Hand Trauma

Interobserver Reliability of Computed Tomography to Diagnose Scaphoid Waist Fracture Union

Buijze GA, The Science of Variation Group (Massachusetts General Hosp, Boston) J Hand Surg 37A:250-254, 2012^§

Abstract

Purpose

To determine the interobserver agreement and diagnostic performance characteristics of computed tomography (CT) for determining union of scaphoid waist fractures.

Methods

A total of 59 orthopedic and trauma surgeons rated for union a set of 30 sagittal CT scans of 30 scaphoid waist fractures. Of these fractures, 20 were treated nonoperatively, were imaged between 6 and 10   weeks after injury, and were known to have eventually achieved union. Ten were operatively confirmed to be ununited. We rated each scan as united or ununited using a Web-based rating application. We assessed interobserver reliability using Siegel’s multirater Kappa. We calculated diagnostic performance characteristics using Bayesian formulas.

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